Most Residents Support SCOTUS Ruling Upholding ACA Subsidies

Nearly two-thirds of U.S. residents agree with the Supreme Court's decision to uphold the Affordable Care Act's subsidies to help individuals purchase health coverage through the federal exchange, according to a Kaiser Family Foundation poll released Wednesday, National Journal reports (Bermel, National Journal, 7/1).

Background

The subsidies were challenged in the case King v. Burwell, but the Supreme Court last month voted 6-3 to uphold them. A ruling striking down the subsidies could have eliminated about $28.8 billion in subsidies to 9.3 million individuals in 34 states in 2016, according to an Urban Institute analysis. Observers say the ruling leaves the law on more stable ground for the remainder of President Obama's time in office (California Healthline, 6/29).

Poll Details, Findings

KFF conducted the poll immediately after the Supreme Court's King v. Burwell ruling was announced on June 25. The poll included responses from 1,202 U.S. adults.

Overall, 62% of respondents said they support the high court's ruling to uphold the subsidies, while 32% of respondents said they oppose the ruling. According to the poll, support for the decision was largely split along party lines, with:

• 82% of Democrats saying they support the ruling;
• 62% of Republicans saying they oppose the ruling; and
• 61% of independent voters saying they support the ruling (National Journal, 7/1).

KFF President and CEO Drew Altman said the poll shows the public thinks the ruling "at a gut level" was based in fairness. He noted many people did not understand why U.S. residents in some states would be able to receive the subsidies, while residents in other states would not (Sun, Washington Post, 7/1).

Further, the poll found 79% of U.S. residents do not believe the King case will be the last major lawsuit to challenge the ACA. According to the poll, about 50% of respondents said debate over health care reform must continue, while 44% of respondents said they are "tired of hearing about the law and think that the country should focus more on other issues" (National Journal, 7/1).

Meanwhile, the poll found the ruling has done little to change the public's overall opinions of the ACA, with 43% of U.S. residents supporting the law and 40% viewing it as unfavorable. In addition, the public remains split on what they think should next be done to address health care reform, with:

• 27% of respondents saying they want Congress to fully repeal the ACA; and
• 25% saying they want Congress to expand the ACA (Washington Post, 7/1).

Separate SCOTUS Decision Could Influence Another ACA Legal Challenge

In related news, lawyers representing House Republicans in a separate  lawsuit challenging some of the Obama administration's actions to implement the ACA say a recent Supreme Court ruling in another unrelated case could help bolster the notion that House members have standing to sue the administration, Modern Healthcare's "Vital Signs."

The House GOP's lawsuit asserts that the administration's delay of the employer mandate falls outside the constitutional powers of the president.

In addition, the suit contends that Congress never authorized funding for the law's cost-sharing reductions to help low-income consumers pay for out-of-pocket costs, such as coinsurance, copayments and deductibles.

In response, the Obama administration has asked the court to dismiss the suit. The administration has said House GOP members themselves were not harmed by the executive action and therefore do not have standing to sue.

U.S. District Judge Rosemary Collyer heard oral arguments for the administration's request to dismiss the suit. According to observers, she seemed skeptical of the request.

According to "Vital Signs," attorneys representing House Republicans last week filed court documents that said the Supreme Court's recent decision in a separate case bolsters the argument that House Republicans have standing to sue the administration.

In that case, the high court in its ruling said the Arizona Legislature had standing to sue the state's executive branch, which the attorneys argued is "relevant" to House Republicans' assertions. The lawyers wrote in the brief, "The State Legislature asserted that it was injured because" a redistricting commission established by a state ballot initiative "'strip(ped) the Legislature of its alleged (constitutional) prerogative to initiate redistricting'" and "The Court agreed that those allegations were sufficient to confer Article III standing on the State Legislature."

According to "Vital Signs," the argument used in the Arizona case is "very similar" to the notion used by House Republicans to argue their standing in their case against the Obama administration.

However, Tim Jost, a law professor at Washington & Lee University, said while the Arizona case is relevant to that waged by House Republicans on the administration, the high court's ruling actually supports the administration's claims that House Republicans do not have standing to sue the president. To support his belief, Jost pointed to a footnote included in the ruling stating the Arizona case "does not touch or concern the question whether Congress has standing to bring a suit against the President." The footnote continues, "There is no federal analogue to Arizona's initiative power, and a suit between Congress and the President would raise separation-of-power concerns absent" in the Arizona case.

In addition, Jost noted that the dissenting opinion in the case, written by Supreme Court Justices Antonin Scalia and Clarence Thomas, stated they did not think the state Legislature had standing (Schencker, "Vital Signs," Modern Healthcare, 7/1).

Clinton Says GOP President Would Repeal ACA

In other related news, former Secretary of State Hillary Clinton, a 2016 Democratic presidential candidate, during a campaign speech on Friday said that a Republican president likely would repeal the ACA, the New York Times' "First Draft" reports.

Clinton applauded the Supreme Court for its ruling to uphold the ACA's subsidies (Haberman, "First Draft," New York Times, 7/3). She said, "I'm so thrilled that we're at a point where all the calls about 'Repeal! Repeal! Repeal!' mean nothing -- unless [U.S. voters] elect a Republican president." She added she is "certain" a Republican president would repeal the law (Rucker, "Post Politics," Washington Post, 7/3).

In contrast, Clinton said she would "defend" the law and "do everything [she] can to improve it," adding that health care access is an issue of "fairness and humanity" and "economics." ("First Draft," New York Times, 7/3).